At 56 years old, after a life of enjoying good health, Seattle Teamster Darrel Taylor was diagnosed with cancer. “I knew that there would be some days where I would need to take some rest,” said Taylor. “Unfortunately, my union contract did not have a paid sick leave component.”

So Taylor, a parking lot attendant, took a lead in lobbying Seattle’s city council to pass a paid sick leave ordinance, which was signed into law last fall and will take effect in September.

“My strongest allies were my fellow union members,” Taylor said. “I’m just happy for the generations of Seattleites who will come to the workforce with the peace of mind knowing that an illness will not make them suffer financially.”

In the past five years, coalitions to win paid sick leave have emerged in half a dozen cities, with victories first in San Francisco and then in Washington, D.C., Seattle, Philadelphia, and the state of Connecticut.

More than 44 million Americans lack access to paid sick leave, and the federal Family and Medical Leave Act does not mandate it. The worker with a cold must choose between seeing his pay docked and hauling himself out of bed to infect co-workers and customers.

In San Francisco, where the first ordinance was established in 2007, workers accrue one hour of paid sick leave for every 30 hours worked. The law has served as a model for the movement in the rest of the country.

In businesses with fewer than 10 employees workers, can collect a maximum of five days per year; in businesses with 10 or more, seven days. Workers are also protected from retaliation for taking sick leave.

The San Francisco law covers not only sickness and injury but treatment and diagnosis, such as a doctor’s appointment or a chemotherapy session. Leave to care for sick spouses, domestic partners, or children is included.

Henry Noble, a former computer programmer who is active in his Machinists retiree chapter, organized other retirees and union members to get out to Seattle city council meetings and rallies. “I was fortunate to have paid sick leave during my career at Boeing,” Noble said. “I believe it’s a basic right.”

PUBLIC HEALTH ISSUE

In the aftermath of the swine flu outbreak in 2009, advocacy groups stressed the public health benefits of paid sick leave. Marilyn Watkins of the Economic Opportunity Institute in Seattle said the coalition there was motivated by knowing that many people, including the bulk of food-service workers, would have to go to work sick.

In Philadelphia, a citywide sick leave law was vetoed by a corporate-friendly Democratic mayor, but a compromise bill that mandated paid leave just for city contractors passed last year. Its effects will be small, so organizers are trying again this year for a broader bill, noting that the 2011 municipal elections produced the largest freshman class on the city council in nearly three decades.

Gwen Snyder, an organizer with Philadelphia Jobs with Justice, sees paid sick leave as a workplace justice issue: “For unions, the work is important because these are reforms that raise the ground for all workers.”

Ellen Bravo, national director of Family Values at Work, the coalition of state affiliates fighting for paid sick leave, said, “Unions see these campaigns as a form of internal organizing,” using them to involve members in a victory and develop leaders.

ENFORCE AND EDUCATE

The only city with enough experience to research the long-term effects of mandating paid sick leave is San Francisco.

A report from the Institute for Women’s Policy Research rebutted the hysterical claims of the business lobby that paid sick leave would dramatically increase the cost of doing business there. San Francisco weathered the great recession better than other counties in the region. The report does raise some concerns, however.

Four years after the ordinance took effect, nearly 16 percent of the workforce continued not to have paid sick leave, in violation of the law. This was an improvement over the situation before 2007—when nearly a third of San Francisco’s workers had no paid sick leave—but it means that only about half the targeted workplaces have complied with the ordinance.

While San Francisco’s law passed as a result of voter initiative, many of the laws in other cities have been weakened by the sausage-making of the legislative process. In Washington, D.C., for example, restaurant workers were excluded from coverage, making some of the public health arguments moot.

The coalitions have been working to make sure that enforcement and education occur after passage, but this could be an uphill climb. A study from the Center for Economic and Policy Research reported that only about half of those eligible for California’s paid family leave fund (which provides compensation for longer-term medical or family leave) are aware that it exists.

And violations of the Family and Medical Leave Act, nearly two decades after its passage, are common. A report from the Labor Project for Working Families indicates that more than 40 percent of employers routinely violate the law.

EMPLOYERS DON’T LET UP

Employers don’t stop trying to weasel out of their obligations just because an ordinance has passed, of course.

Eileen Prendiville, an RN at the notoriously anti-worker California Pacific Medical Center in San Francisco, saw her union contract expire right when the paid sick leave ordinance was being implemented. CPMC wanted the nurses to waive their rights under the law, as the full-time RNs would already be covered by a clause in their contract.

San Francisco’s law, like Seattle’s, allows collective bargaining agreements to supersede the ordinance. Employers subject to collective bargaining agreements that do not specifically require workers to waive their rights, however, must follow the law.

“For two years, they wanted us to waive the ordinance, but we wouldn’t do it because the per diem nurses would benefit from it,” Prendiville said. “We don’t want nurses coming to work sick.” Per diem nurses, hired by the day, are about 20 percent of Prendiville’s unit.

After two years of fighting, CPMC ultimately dropped its demand.

Despite the hiccups, the national movement continues to expand. A new campaign is beginning in Massachusetts, and a coalition in New York City is actively pressing for a bill this year.